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  Copyright (C) 2012 - 2020 Facilitaire Samenwerking Bevolkingsonderzoek
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<html xmlns:wicket="http://wicket.apache.org">
<wicket:panel>
    <h2>Huisarts darmkanker</h2>
    <fieldset class="row-fluid" style="width: 95%">
        <div class="span6">
            <div class="control-group value">
                <label class="control-label">Naam huisarts</label>
                <div class="controls"><span wicket:id="huisartsNaam">Dhr. A.C. Haanraads</span></div>
            </div>
            <div class="control-group value">
                <label class="control-label">Praktijknaam</label>
                <div class="controls"><span wicket:id="praktijkNaam">Huisartspraktijk Haanraads en Severins</span></div>
            </div>
            <div class="control-group value">
                <label class="control-label">Adres</label>
                <div class="controls"><span wicket:id="praktijkAdres">Stationsweg 25a, Deventer</span></div>
            </div>
            <div class="control-group value">
                <label class="control-label" wicket:message="title:title.edifactadres">EDI-fact adres</label>
                <div class="controls"><span wicket:id="ediadres">012234@lms.lifeline.nl</span></div>
            </div>
        </div>
        <div class="span6">
            <div class="control-group value">
                <label class="control-label">AGB-Code huisarts</label>
                <div class="controls"><span wicket:id="huisartsAgb">00345678</span></div>
            </div>
            <div class="control-group value">
                <label class="control-label">Weergave naam</label>
                <div class="controls"><span wicket:id="weergaveNaam">haanraads</span></div>
            </div>
            <div class="control-group value">
                <label class="control-label">Klantnummer</label>
                <div class="controls"><span wicket:id="klantnummer">123456789</span></div>
            </div>
            <div class="control-group value">
                <label class="control-label" wicket:message="title:title.communicatieadres">Communicatieadres</label>
                <div class="controls"><span wicket:id="communicatieadres">012234@lms.lifeline.nl</span></div>
            </div>
        </div>
    </fieldset>
</wicket:panel>
</html>
